Chocolate is the culprit for me as well. Sometimes sugar too, but, not as frequently or as much as chocolate (but the acne seems subtly different from the chocolate one).
Out of curiosity, does chocolate have any other effects on you besides the acne? Like easier bleeding/blood thinning? Or other inflammation besides acne? It has more than one effect on me and I surely can't be the only one observing it.
I consume chocolate in the evening and do sometimes clear walking tracks before breakfast, which often involves scratches. So I would expect to have noticed wounds bleeding for longer than usual.
Try comparing British to American process chocolate. Makes a huge difference for my wife. American chocolate triggers a bad outbreak. Different chemical process, different quality of ingredients.
I would add possibly polluted or adulterated dairy. Raw milk (anecdote) may not cause the same issues as processed dairy.
Also, I would add that most processed dairy (besides just plain old milk) is mixed with many other detrimental ingredients. So there may be a cause/effect relationship overlap with other foods.
I can't speak for other people's cases but in my case it's definitely not the dairy. The only time dairy ever had an effect on me was pre-elementary school when eating too many egg started giving me pimples, so I cut down on that and that fixed it. Never had a problem with it again.
If you are in the Bay Area check out Acneology or the US Face reality clinics. They basically have the whole science of acne treatment down to almost perfection. Dermatology didn't help me at all but their treatments worked wonders. I'll give out more info if anyone is interested. Source - I've had acne for a decade :( more or less cleared up now.
Read my reply below. The prescriptions are standard the pore unclogging/extractions and peels are the real differentiator. Oh yeah and the Diet restrictions.
This very little evidence that diet affects acne. I'm glad you found a solution, but food probably had little to do with it. Especially "greasy" food, which is one of the items they list on their website.
They also say that antibiotic solutions are a "myth", which is patently false.
There are several kinds of acne. The kind that you get when you hit puberty is not related to diet. Adult acne in most cases is however.
The thing is food does not directly cause acne. The logic is pretty simple actually. Acne causing bacteria grow in blocked pores and greasy food and dairy makes me super oily . More sebum more blocked pores aaand more acne.
Their treatment regimen goes something like this, You have a session with an esthetician who will assess your acne severity. They will give you a list of food to avoid and to no one's surprise it contains dairy and greasy foods http://www.thefacialroom.com/upload/FOODS%20AND%20LIFESTYLE%...
After that you'll have monthly sessions where they unclog all your pores(called extractions) and remove white heads afte that Peels for the hyper pigmentation.
You'll be prescribed benzoyl perioxide and mandelic serum for acne and hyperpigmentation.
After a few sessions all your pores are clean and tight and bam almost no more acne.
The peels and mandelic serum worked wonders for my hyper pigmentation.
If you are in the bay area I can give you the address of the clinic I go to.